Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

Vale, Francisco Assis Carvalho; Miranda, Stênio José Correira de

doi:10.1590/s0004-282x2002000400006

Cited by 37 publications

(43 citation statements)

References 17 publications

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“…It is necessary more studies in different regions of our country about early onset dementia, and the ones with senile dementia clearly has showed AD as principal cause of dementia [9][10][11][12][13] . Collaborative researches can clarify this picture.…”

Section: Discussionmentioning

confidence: 99%

“…There are no studies analyzing the prevalence of presenile dementia in our country in a search in MEDLINE. Other authors have reported diagnostic prevalence in senile dementia or overall rates of dementia in their outpatient clinics [9][10][11][12] or institutionalized patients 13 . One report was presented as abstract and has reviewed a considerable number of patients (n= 619) and found a prevalence of 28.6% of presenile dementia 14 .…”

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confidence: 99%

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Prevalence of presenile dementia in a tertiary outpatient clinic

Fujihara

Brucki

Rocha

et al. 2004

Arq. Neuro-Psiquiatr.

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-There are very few reports about prevalence of presenile dementia in Brazil. We reviewed files of patients evaluated with early onset of cognitive impairment in our institution. Among 141 patients (61% males) there was no difference between gender by age at onset or at first evaluation. We have observed an increasing number of patients after 50 years. The most frequent causes were: vascular dementia (36.9%), Alzheimer's disease (20.3%) and traumatic brain injury (9.2%). There was difference among dementia type by age of onset and first evaluation, educational level and length of dementia. These results may be compared with those from other neurologic services in order to replicate or confirm these results.KEY WORDS: presenile dementia, vascular dementia, Alzheimer's disease, epidemiology. Prevalência de demência pré-senil num ambulatório terciárioRESUMO -Em nosso meio há raros estudos que verifiquem quais as causas mais prevalentes de demência pré-senil. Avaliamos retrospectivamente os prontuários de pacientes com início precoce de alterações cognitivas, ambulatório de Neurologia da Cognição do Hospital Santa Marcelina. Entre os 141 sujeitos (61% de homens) não houve diferença quanto às idades de início e à primeira consulta e escolaridade entre os sexos. Observamos aumento no número de demência após os 50 anos. A causa mais freqüente foi vascular (36,9%), seguida por doença de Alzheimer (20,3%) e secundária a trauma cranio encefálico (9,2%). Houve diferença entre os tipos de demência quanto à idade na primeira consulta e idade de início, escolaridade e duração do quadro. Ao contrário de outros estudos o diagnóstico mais freqüente foi demência vascular. Novos estudos em nosso meio deverão ser realizados para avaliar este achado nas demências de início precoce.PALAVRAS-CHAVE: demência pré-senil, demência vascular, doença de Alzheimer, epidemiologia.Dementia is a disorder of greater prevalence in older subjects, but many cases can begin in an early age, affecting people in a productive phase of their lives. A syndrome characterized by many cognitive deficits of sufficient severity to interfere with daily life activities and in quality of life. It is a public health problem due its expensive treatment and dependence of patients for governmental sources for sustainability. There are a few studies in epidemiology of presenile dementia comparing to an older onset or familiar Alzheimer's disease (AD) [1][2][3] . The prevalence of presenile dementia is lower that ones with onset in the elderly. Harvey et al. 4 reported that the prevalence increases exponentially between 45 to 60 years of age; this finding was replicated by another three epidemiological studies [5][6][7] . The most frequent diagnosis in early onset dementia is:Alzheimer's disease, followed by vascular dementia (VaD) and frontotemporal dementia (FTD) 8 . There are no studies analyzing the prevalence of presenile dementia in our country in a search in MEDLINE. Other authors have reported diagnostic prevalence in senile dementia or overall rates o...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence of presenile dementia in a tertiary outpatient clinic

Fujihara

Brucki

Rocha

et al. 2004

Arq. Neuro-Psiquiatr.

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“…While memory clinics in developed countries have reported prevalence rates of 50 -62% for AD and 7 -20% for vascular dementia (VaD), 22 our audit showed an AD prevalence of 44%, compared with 36% in a Brazilian memory clinic. 23 Our high prevalence of VaD (28%) and mixed dementia (15%) suggests a high prevalence of stroke and attendant risk factors that may be inadequately managed.…”

Section: Clinical Diagnosesmentioning

confidence: 93%

Profile and management of patients at a memory clinic

Kalula

Ferreira

Thomas³

et al. 2010

S Afr Med J

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“…All over the country, few outpatient units mostly from the university [7][8][9][10] , have trained specialists and have given assistance to older persons with dementia and other related disorders, whereas primary and tertiary care are still difficult to find.…”

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confidence: 99%

Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

Verdan

Casarsa

Perrout

et al. 2014

Arq. Neuro-Psiquiatr.

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We describe a three-year experience with patients with dementia. Method: clinical, cognitive and functional evaluation was performed by a multidisciplinary team for persons above 60 years. Mortality was assessed after three years. Results: Mini-Mental State Examination (MMSE) (n=2,074) was 15.7 (8.4). Male patients MMSE (n=758) was 15.6 (8.3) and female's (n=1315) was 15.8 (8.3). Instrumental Activities of Daily Living Scale (n=2023) was 16.5 (7.6); females (n=1277) was 16.9 (7.2) and males (n=745) was 15.7(8.2). From these patients, 12.6% (n=209) died within three years. Baseline cognition of patients still alive was higher (p,0.001) than MMSE of those who died [MMSE=16.3 (8.1) vs. 10.6 (7.6)]. Mortality rate decreased 6% (IR=0.94) for each additional point on MMSE. Higher functional status decreases the mortality rate approximately 11% (IR=0.89) independently of age, gender, and education. Conclusion: Three-year mortality rates are dependent on baseline functional and cognitive status Keywords: Alzheimer's disease, activities of daily living, Mini-Mental State Examination, mortality, outpatient service, Brazil. RESUMODescreve-se experiência de três anos em relação à mortalidade em pacientes diagnosticados com demência. Método: Foi feita avaliação clínica, cognitiva e funcional por equipe multidisciplinar em pessoas com mais de 60 anos. Mortalidade foi aferida no período de três anos. Resultados: O teste do Mini Exame do Estado Mental (MEEM) (n=2.074) foi 15,7 (8,4). MEEM dos homens (n=758) foi 15,6 (8,3) e das mulheres (n=1315) foi 15,8 (8,3). As atividades da vida diária (AVD) (n=2023) foi 16,5 (7,6); nas mulheres (n=1277) foi 16,9 (7,2) e nos homens (n=745), 15,7(8,2). Do total de pacientes, 12,6% (n=209) morreram em 3 anos. O estado cognitivo basal dos pacientes vivos ao final dos 3 anos era maior (p,0.001) que o daqueles que morreram [MEEM=16,3 (8,1) vs. 10,6 (7,6)]. Mortalidade decresceu 6% (IR=0,94) para cada ponto adicional no MEEM, ajustado para idade, gênero e educação. Mortalidade decresce em 11% (IR=0,89) independentemente da idade, gênero e educação para funcionalidade mais alta. Conclusão: A mortalidade em três anos depende do estado funcional e cognitivo basal.Palavras-chave: doença de Alzheimer, atividades de vida diária, Mini Exame do Estado Mental, mortalidade, Brasil.The latest Brazilian census has shown that people with more than 65 years of age account for 21,736,000 (11.3%) of the total population (IBGE, 2010) 1 . Data from 2000 show that despite being 9% of the total population at that time, older persons were responsible for as much as 26% of the expenditures with hospitalizations in the whole country 2 . The state of Rio de Janeiro concentrates the highest rate of older persons in the country, totaling 2,376,000 inhabitants (15%). However, to this date there is no direct study on the epidemiology of dementia, depression, and Parkinson's disease in Rio de Janeiro. If one is to calculate prevalence rates of these disorders considering the studies performed in the southern and s...

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Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

Cited by 37 publications

References 17 publications

Prevalence of presenile dementia in a tertiary outpatient clinic

Prevalence of presenile dementia in a tertiary outpatient clinic

Profile and management of patients at a memory clinic

Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

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